Bacterial and fungal co-infections among ICU COVID-19 hospitalized patients in a Palestinian hospital: a retrospective cross-sectional study

Background: Diagnosis of co-infections with multiple pathogens among hospitalized coronavirus disease 2019 (COVID-19) patients can be jointly challenging and essential for appropriate treatment, shortening hospital stays and preventing antimicrobial resistance. This study proposes to investigate the burden of bacterial and fungal co-infections outcomes on COVID-19 patients. It is a single center cross-sectional study of hospitalized COVID-19 patients at Beit-Jala hospital in Palestine. Methods: The study included 321 hospitalized patients admitted to the ICU between June 2020 and March 2021 aged ≥20 years, with a confirmed diagnosis of COVID-19 via reverse transcriptase-polymerase chain reaction assay conducted on a nasopharyngeal swab. The patient's information was gathered using graded data forms from electronic medical reports. Results: The diagnosis of bacterial and fungal infection was proved through the patient’s clinical presentation and positive blood or sputum culture results. All cases had received empirical antimicrobial therapy before the intensive care unit (ICU) admission, and different regimens during the ICU stay. The rate of bacterial co-infection was 51.1%, mainly from gram-negative isolates (Enterobacter species and K.pneumoniae). The rate of fungal co-infection caused by A.fumigatus was 48.9%, and the mortality rate was 8.1%. However, it is unclear if it had been attributed to SARS-CoV-2 or coincidental. Conclusions: Bacterial and fungal co-infection is common among COVID-19 patients at the ICU in Palestine, but it is not obvious if these cases are attributed to SARS-CoV-2 or coincidental, because little data is available to compare it with the rates of secondary infection in local ICU departments before the pandemic. Comprehensively, those conclusions present data supporting a conservative antibiotic administration for severely unwell COVID-19 infected patients. Our examination regarding the impacts of employing antifungals to manage COVID-19 patients can work as a successful reference for future COVID-19 therapy.

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Bacterial and Fungal Co-Infections among ICU COVID-19 Hospitalized Patients in a Palestinian Hospital: Incidence and Antimicrobial Stewardship

10.1101/2021.09.12.21263463 ◽

2021 ◽

Author(s):

Hani A. Naseef ◽

Ula Mohammad ◽

Nimeh Al-Shami ◽

Yousef Sahoury ◽

Abdallah D. Abukhalil ◽

...

Keyword(s):

Cross Sectional Study ◽

Hospitalized Patients ◽

Nasopharyngeal Swab ◽

Rt Pcr ◽

Cross Sectional ◽

Appropriate Treatment ◽

Enterobacter Species ◽

Medical Reports ◽

Patient’S Information ◽

Multiple Pathogens

AbstractDiagnosis of co-infections with multiple pathogens among hospitalized COVID-19 patients can be jointly challenging and very essential for appropriate treatment, shortening hospital stay and preventing antimicrobial resistance. This study proposes to investigate the burden of bacterial and fungal co-infections outcomes on COVID-19 patients. It is a single centre cross-sectional study of hospitalized COVID-19 patients at Beit-Jala hospital in Palestine. The study included 321 hospitalized patients admitted to the ICU between June 2020 and March 2021 aged ≥ 20 years, with a confirmed diagnosis of COVID-19 via RT-PCR conducted on a nasopharyngeal swab. The patient’s information was gathered using graded data forms from electronic medical reports. The diagnosis of bacterial and fungal infection was proved through the patient’s clinical presentation and positive blood or sputum culture results. All cases had received empirical antimicrobial therapy before the ICU admission, and different regimens during the ICU stay. The rate of bacterial co-infection was 51.1%, mainly from gram-negative isolates (Enterobacter species and K.pneumoniae). The rate of fungal co-infection caused by A.fumigatus was 48.9%, and the mortality rate was 8.1%. However, it is unclear if it had been attributed to SARS-CoV-2 or coincidental.

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THE SITUATION OF RECOGNITION OF SOME NON-COMMUNICABLE DISEASES AND TREATMENT AND PREVENTIVE BEHAVIORS OF PEOPLE IN THUA THIEN HUE PROVINCE

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2019.1.13 ◽

2019 ◽

pp. 80-86

Author(s):

Phuoc Thuoc Doan ◽

Thi Huong Nguyen ◽

Thi Thanh Nhan Tran ◽

Thi Phuong Thao Nguyen ◽

Thi Thuy Hang Nguyen ◽

...

Keyword(s):

Dietary Habits ◽

Cross Sectional Study ◽

Communicable Diseases ◽

Sectional Study ◽

Preventive Behaviors ◽

Cross Sectional ◽

Non Communicable Diseases ◽

Treatment And Prevention ◽

Knowing That ◽

Appropriate Treatment

Background: Non-communicable diseases seriously affect public health and socio-economic development of the country due to the high number of people suffering from diseases, being disabled and mortal. However, the proportion of people who recognized themselves a suffering from non-communicable diseases such as hypertension, diabetes and dyslipidemia is not high. For cases that their disease situations have been identified, there are not appropriate treatment and preventive behaviors. Objectives: 1) To determine the proportion of 25 - 84 years old peoplewho identified themselves as suffering from hypertension, diabetes and dyslipidemia. 2) To learn treatment and preventive behaviors in the group of people who identified themselves as suffering from diseases. Methods: A cross-sectional study was conducted with a randomly selected sample of 1600 residents in Thua Thien Hue province. Results: The proportion of people knowing that they are suffering from hypertension, diabetes and dyslipidemia was 29.4%; 3.2% and 7.8% respectively. Among them, the proportion of people who did not treat and treated irregularly accounted for 42.7%; 13.7% and 75.2% respectively; the proportion of people who did not change their lifestyles and dietary habits accounted for 50.1%; 5.9% and 56.8% respectively. Conclusions: The proportion of people who identified themselves as suffering from some non-communicable diseases without appropriate treatment and preventive behaviors is alarming. Interventions are needed to help people realize the importance of treatment and prevention effectively. Key words: Non-communicable diseases, hypertension, diabetes, dyslipidemia

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Etiologies, Clinical Manifestations, and Factors Associated with Severe Symptomatic Hyponatremia among Hospitalized Hyponatremia Patients

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.05.10937 ◽

2020 ◽

Vol 103 (5) ◽

pp. 465-471

Keyword(s):

Clinical Manifestations ◽

Cross Sectional Study ◽

Hospitalized Patients ◽

Sectional Study ◽

Close Attention ◽

Cross Sectional ◽

Factors Associated ◽

Present Cross Sectional Study ◽

Important Health ◽

Baseline Characteristics

Background: Hyponatremia is associated with unfavorable outcomes in many cases. The mainstay of hyponatremia treatment depends on its symptoms and etiology. However, etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia have been rarely reported. Objective: To analyze and report etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia. Materials and Methods: In the present cross-sectional study, the authors enrolled hospitalized patients with hyponatremia who had consulted a nephrologist between October 1, 2017, and October 31, 2018. Their baseline characteristics and clinical manifestations were recorded. Etiologies were confirmed by the attending nephrology staff. Factors associated with severe symptomatic hyponatremia were evaluated using logistic regression analysis. Results: One hundred patients were included in this study. The syndrome of inappropriate antidiuresis (SIAD), hypovolemia, and hydrochlorothiazide use were the leading hyponatremia etiologies. Hyponatremia etiologies differed between patients with community-acquired hyponatremia (n=50) and those with hospital-associated hyponatremia (n=50). Patients with communityacquired hyponatremia were older, presented with a higher frequency of severe symptomatic hyponatremia, and showed lower SNa-levels. Low SNa-levels were significantly associated with severe symptomatic hyponatremia (p=0.014). Conclusion: Hyponatremia remains an important health problem. SIAD, hypovolemia, and hydrochlorothiazide use are among the leading etiologies of hyponatremia. Low SNa-levels are associated with severe symptomatic hyponatremia; thus, physicians should pay close attention to low SNa-levels in hospitalized patients. Keywords: Hyponatremia, Symptomatic Hyponatremia, Community-acquired hyponatremia, Hospital-associated hyponatremia

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SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study

Thorax ◽

10.1136/thoraxjnl-2020-215414 ◽

2020 ◽

Vol 75 (12) ◽

pp. 1089-1094 ◽

Cited By ~ 22

Author(s):

Adrian Shields ◽

Sian E Faustini ◽

Marisol Perez-Toledo ◽

Sian Jossi ◽

Erin Aldera ◽

...

Keyword(s):

Intensive Care ◽

Healthcare Workers ◽

Venous Blood ◽

Cross Sectional Study ◽

Nasopharyngeal Swab ◽

Sectional Study ◽

University Hospitals ◽

Cross Sectional ◽

General Internal ◽

Increased Risk

ObjectiveTo determine the rates of asymptomatic viral carriage and seroprevalence of SARS-CoV-2 antibodies in healthcare workers.DesignA cross-sectional study of asymptomatic healthcare workers undertaken on 24/25 April 2020.SettingUniversity Hospitals Birmingham NHS Foundation Trust (UHBFT), UK.Participants545 asymptomatic healthcare workers were recruited while at work. Participants were invited to participate via the UHBFT social media. Exclusion criteria included current symptoms consistent with COVID-19. No potential participants were excluded.InterventionParticipants volunteered a nasopharyngeal swab and a venous blood sample that were tested for SARS-CoV-2 RNA and anti-SARS-CoV-2 spike glycoprotein antibodies, respectively. Results were interpreted in the context of prior illnesses and the hospital departments in which participants worked.Main outcome measureProportion of participants demonstrating infection and positive SARS-CoV-2 serology.ResultsThe point prevalence of SARS-CoV-2 viral carriage was 2.4% (n=13/545). The overall seroprevalence of SARS-CoV-2 antibodies was 24.4% (n=126/516). Participants who reported prior symptomatic illness had higher seroprevalence (37.5% vs 17.1%, χ2=21.1034, p<0.0001) and quantitatively greater antibody responses than those who had remained asymptomatic. Seroprevalence was greatest among those working in housekeeping (34.5%), acute medicine (33.3%) and general internal medicine (30.3%), with lower rates observed in participants working in intensive care (14.8%). BAME (Black, Asian and minority ethnic) ethnicity was associated with a significantly increased risk of seropositivity (OR: 1.92, 95% CI 1.14 to 3.23, p=0.01). Working on the intensive care unit was associated with a significantly lower risk of seropositivity compared with working in other areas of the hospital (OR: 0.28, 95% CI 0.09 to 0.78, p=0.02).Conclusions and relevanceWe identify differences in the occupational risk of exposure to SARS-CoV-2 between hospital departments and confirm asymptomatic seroconversion occurs in healthcare workers. Further investigation of these observations is required to inform future infection control and occupational health practices.

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Spiritual needs of geriatric hospitalized patients and the associations with depressive symptoms and pain intensity: a cross-sectional study in Belgium

Journal of Religion Spirituality & Aging ◽

10.1080/15528030.2021.1928584 ◽

2021 ◽

pp. 1-23

Author(s):

Lindsy Desmet ◽

Jessie Dezutter ◽

Anna Vandenhoeck ◽

Annemie Dillen

Keyword(s):

Depressive Symptoms ◽

Pain Intensity ◽

Cross Sectional Study ◽

Hospitalized Patients ◽

Spiritual Needs ◽

Sectional Study ◽

Cross Sectional

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Fever without source as the first manifestation of SARS-CoV-2 infection in infants less than 90 days old.

10.21203/rs.3.rs-175195/v1 ◽

2021 ◽

Author(s):

Daniel Blázquez-Gamero ◽

Cristina Epalza ◽

José Antonio Alonso Cadenas ◽

Lourdes Calleja Gero ◽

Cristina Calvo ◽

...

Keyword(s):

Bacterial Infections ◽

Urine Culture ◽

Pediatric Intensive Care ◽

Cross Sectional Study ◽

Nasopharyngeal Swab ◽

Sectional Study ◽

Cross Sectional ◽

Bacterial Coinfection ◽

Growth Of Bacteria ◽

Rule Out

Abstract Fever without source (FWS) in infants is a frequent cause of consultation at the emergency department and the emergence of SARS-CoV-2 could affect the approach to those infants. The aim of this study is to define the clinical characteristics and rates of bacterial coinfections of infants < 90 days with FWS as the first manifestation of SARS-CoV-2 infection. This is a cross-sectional study of infants under 90 days of age with FWS and positive SARS-CoV2 PCR in nasopharyngeal swab/aspirate, attended at the emergency departments of 49 Spanish hospitals (EPICO-AEP cohort) from March 1st to June 26th, 2020. Three hundred and thirty-three children with COVID-19 were included in EPICO-AEP. A total of 67/336 (20%) were infants less than 90 days old, and 27/67(40%) presented with FWS. Blood cultures were performed in 24/27(89%) and were negative in all but one (4%) who presented a Streptococcus mitis bacteremia. Urine culture was performed in 26/27(97%) children and was negative in all, except in two (7%) patients. Lumbar puncture was performed in 6/27(22%) cases, with no growth of bacteria. Two children had bacterial coinfections: 1 had UTI and bacteremia, and 1 had UTI. C-reactive was protein over 20 mg/L in two children (one with bacterial coinfection), and procalcitonin was normal in all. One child was admitted to the Pediatric Intensive Care Unit because of apnea episodes. No patients died. Conclusion: FWS was frequent in infants under 90 days of age with SARS-CoV-2 infection. Standardized markers to rule out bacterial infections remain useful in this population, and the outcome is generally good.

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